Over the holidays, Scott Sundheim traded his bedroom eye for bar-fight eyes.
Or so it seemed, anyway, for days after his plastic surgery on Dec. 17, which lifted his perpetually sleepy left lid and tightened the right one for symmetry.
“For about a week, it was like my eyes were sewn shut,” said Sundheim, 31, of Wheaton, who works in marketing. “My baby looked at me the first time I got back–she’s only 7 months old–but she looked at me, like, ‘Who is this weird guy in my house?’ “
His surgeon, Dr. Allen Putterman of Chicago, told him it would get worse before it got better.
“And it did,” Sundheim said.
“But definitely at this point,” he said, “I’m very excited about the results.”
Even as other eyes are closing to some glaringly “overcorrected” celebrities in the news, more male minds and wallets are opening to moderate cosmetic surgeries such as Sundheim’s. The desire for privacy prevails, but a few now are willing to open their mouths about their ventures too.
Men represent a growing percentage of plastic surgery patients, 21 percent for surgical procedures in 2002, up from about 11 percent in 1998, according to the Chicago-based American Society of Plastic Surgeons.
Nose reshaping (rhinoplasty) is the most popular surgical procedure among them, followed by liposuction, which is also No. 2 for women (No. 1 is breast augmentation). The third for men? Eyelid surgery (blepharoplasty), entailing muscle-tightening and skin removal. Several Chicago surgeons said they’re performing it more often these days as baggy-eyed men reach a “have-a-hard-weekend?” breaking point.
In younger men, trauma or a congenital defect is the motivation.
In Sundheim’s case, a portion of the procedure was covered by medical insurance. At age 14, he was standing in the wrong place during the backswing of a golf club, and he attributes some of the drooping and vision interference from his left eyelashes to that blood-gushing thwack.
Even so, “if you had told me 10 years ago about males doing cosmetic surgery, I would have said they’re vain and that’s feminine of them,” Sundheim said.
Not wanting to draw stares
In recent years, however, he became preoccupied with whether business associates were fixating on his left eye.
“I’m constantly selling ideas, presenting,” he said. “If I want to move up, I want to make sure I look good. . . . I know the self-esteem [boost] in the long term is going to make up for any comments in the short term.”
By no means has cosmetic surgery become as routine for men as, say, clipping nose hairs to avoid driving clients to distraction. The total of male surgical patients in 2002 was just 339,587 in the U.S., compared with more than 1.2 million women. When non-surgical procedures are included, the totals are 966,821 for men compared with about 5.6 million women.
“It’s not cheap, either,” said Sundheim, who paid about $3,500 out of pocket for his $6,000 surgery.
But this sort of makeover, it seems, is becoming ex-extreme in public discourse. That can be traced in part to all the TV shows on the subject–ABC’s “Extreme Makeover” included–and other mainstream exposure, whether rumored or real.
Presidential contender Sen. John Kerry has dismissed gossip that he has had Botox injections. Last month, Italian Prime Minister Silvio Berlusconi acknowledged that he had plastic surgery “only under the eyes.”
“Many males, just as females in the Baby Boomer era, don’t want to age gracefully,” said Dr. Rod Rohrich, president of the American Society of Plastic Surgeons and plastic-surgery chairman at the University of Texas Southwestern Medical Center in Dallas. “They want to manage their age.”
For men in their 30s and 40s, that increasingly means chemical peels, Botox and microdermabrasion, the top three non-surgical procedures. Restylane, an injectable filler for wrinkles and folds that was approved recently by the Food and Drug Administration, also is gaining popularity quickly.
How about the costs?
With subtler, shorter-term effects, non-surgical procedures require minimal downtime and cost less than surgery, of course.
Physician fees vary widely, but the 2002 national averages were $422 for a Botox injection and $446 for a chemical peel, compared with $5,352 for a face-lift, according to Rohrich’s society. Rhinoplasty was $3,469; liposuction $2,074. (Fees exclude any anesthesia and operating-room charges.)
“Most males don’t want to look like another species,” said Rohrich, referring to the Michael Jacksons of the world as isolated cases and “a tragedy, really.”
Rohrich sees three R’s of treatment emerging.
“You can relax [wrinkles] with Botox, refill [folds] with Restylane and then redrape [later] with a face-lift. That’s the continuum.”
It’s a continuum that some have adapted earlier and more heartily than others ever will.
Hairdresser Maurice Bonamigo, 44, who splits his time between Chicago and Palm Beach, Fla.–where he says “you could bounce a quarter off” the faces of many society women–had a nose job three or four years ago and his eyes done two years ago. Now he schedules regular Botox dates, all with Skokie plastic surgeon Loren Schechter.
“I just tell him, `Put in as much poison as you want in this face,'” Bonamigo said, referring to Botox, derived from a neurotoxin to paralyze furrow-inducing muscles.
How much has Bonamigo invested in plastic surgery with Schechter?
“How much is a new Carrera?” he rhetorically answers. “With my surgeries, I think I’ve bought him a Porsche. But it’s well-deserved.”
Wind-swept looks are passe
Whether for frequent or one-time cosmetic patients, advances in technique prevent that permanently wind-swept or petrified look of the past.
“Gone are the days of taking out as much skin and fat [as possible]–the excavation procedures,” Rohrich said of eyelid surgery. “You were really making the face and eyes look older. Today we’re more into resuspending to give a more youthful, non-operated appearance.”
Liposuction in men, typically in the love-handle zone, previously posed a greater challenge than in women, Rohrich said, because men’s fat tends to be more fibrous.
“That’s where ultrasound liposuction, which melts that hard fat, has revolutionized liposuction in males,” Rohrich said. “You can remove it much easier and sculpt it much better.”
In rhinoplasty, the advent of what Rohrich calls the “open approach,” involving a small incision in the bottom of the nose from which the skin is peeled back, allows surgeons to operate with more visibility, precision and predictability.
These improvements don’t mean that cosmetic surgery is a breeze for the patient either, though shows such as FX’s “Nip/Tuck” might have viewers believe otherwise.
“Males tend to be–how do I put this tactfully–males aren’t quite as good of patients as females in cosmetic surgery. We don’t seem to listen as well–you’re shocked, I know,” he said, dryly. “We expect a faster recovery even though we’re told it’s not.”
The trends in hair loss
Nor does the overall rise mean that all procedures are gaining momentum.
Hair transplants remain the No. 4 male surgical procedure and also have benefited from advances in technique. Follicles harvested typically from the back of the head now are divided into tinier thatches before being moved up front, for a more natural look.
But the number of procedures fell a little from 2001 to 2002, according to Rohrich’s society.
The society bases its numbers on about 18,000 surveys sent to its members, certified by the American Board of Plastic Surgery, as well as other doctors certified by boards recognized by the American Board of Medical Specialties.
“[Hair transplants] are far less common than rhinoplasty,” Rohrich said. “The current trend for men is, if they’re going bald, they will tend to shave their heads.”
Like trends, any benefits of meddling with Mother Nature don’t last forever. And there are risks.
But more than a year after having a liter and a half of fat removed through ultrasound liposuction, Chicago financial consultant Ross Wittgren, 59, has maintained his 170-pound weight and 32-inch waist, down about 10 pounds and 2 inches from his pre-lipo stats.
Surgeons stress that liposuction is never a treatment for obesity.
But Wittgren mountain-bikes and ice-climbs and was perhaps leaner than the typical patient to begin with.
He underwent it partly because his wife, who at that time was a technician with a plastic surgeon in Northbrook, Dr. Michael Byun, wanted volunteers for their new line of liposuction equipment.
Sure, vanity is a factor
But vanity–and value in the workplace–was the bigger trigger for him, he said.
“You look at who people would like to hire, and it’s proven over and over that someone who’s thin or attractive is getting the job,” he said.
The lipo targeted Wittgren’s love handles and also the “gooey stuff” under the chin and down each cheekbone.
“It was the face that really was more dramatic,” Wittgren said of his results. “Everybody noticed there was a change, but it was so subtle they couldn’t figure out what it was they were looking at.
“They said, `So what have you been doing? Increasing your bike riding? Special diet or something?'”
He said he answered simply, “No, I had liposuction.”
Board-certified? But in what, exactly?
It has become almost as cliche as the “take two aspirin” refrain: Make sure your doctor is board-certified.
Problem: That tells a plastic surgery patient very little if he or she doesn’t also ask, “In what?”
Is the doctor board-certified in plastic surgery? Or one of the other 23 specialties under the umbrella of the American Board of Medical Specialties?
Many doctors who carry ABMS board-certification in, say, ophthalmology or dermatology expertly perform certain plastic surgery procedures, even if they don’t have the plastic surgery board certification. But ask them to explain the relationship of their certification to your procedure.
What if the doctor says he’s certified in “cosmetic surgery”?
The ABMS, based in Evanston, offers certification in plastic surgery, which encompasses an area of practice called “cosmetic surgery.” But it has no board of cosmetic surgery, and offers no certification in it.
That isn’t a blanket indictment of a doctor with other kinds of credentials. “It just means it’s not the routine way [to establish them],” said Dr. Stephen H. Miller, executive vice president of the ABMS. So seek more information–at what university did the doctor train? What sort of residency program? Etc.
Should you seek patient references?
Yes, but beware of a doctor who produces three people who “call you right back bragging about a doctor,” Dr. Michael Byun, who is board-certified in plastic surgery, said. Maybe they are operating under an incentive besides goodwill.
How about before/after photos of former patients?
Useful. But remember computer images can be chosen (and even manipulated) to reflect stellar work. Ask whether the photos are an average result and out of how many, suggests Dr. Loren Schechter, board-certified in plastic surgery.
Should you heed “top doctors” rankings in magazines?
Note that magazines sometimes sell related advertising when they focus on a topic, and it can be hard to tell which is which. Read the fine print.
Finally, is this any of your family doctor’s business?
Definitely. A primary-care doctor may be able to refer you to plastic surgeons and prescreen you–particularly if you have a condition that could cause complications.
Other questions? The American Society of Plastic Surgeons Web site is www.plasticsurgery.org. Its sister society, The American Society for Aesthetic Plastic Surgery, is www.surgery.org. The American Board of Medical Specialties is www.abms.org.
–W.N.
